A pilot study of telemedicine for new neurological outpatient referrals

Abstract

We investigated whether new patients attending a neurological outpatient clinic could be safely managed by neurologists at a distance, using a video-link. In Northern Ireland, a video-link, transmitting at 384 kbit/s, was set up between a neurological centre and a small rural hospital 140 km away. Twenty-five unselected patients who had been referred by their family doctor were assessed by a neurologist using the telemedicine link and then immediately by another neurologist face to face. Examiners were blinded to the results of each other's assessment. In 24 cases the diagnoses made after the telemedicine and face-to-face examinations were identical. There were minor differences between the type and number of investigations requested, and the requirements for treatment and follow-up between the two groups. Disposal method was the same in 21 of the cases. No major organizational difficulties were encountered during the study. The study showed that neurologists can deliver outpatient neurological care to distant patients using telemedicine. This has the potential to allow access to assessment for the large number of neurological outpatients who might otherwise be denied it.

Long-term outcome after thrombolysis in telemedical stroke care

“…6 Recently, telemedical stroke networks have been established to support local community hospitals. 5,[7][8][9][10][11] It could be demonstrated that a neurologic examination 12,13 and National Institute of Health Stroke Scale (NIHSS) 14,15 administration is feasible by means of telemedicine. Few patients received telethrombolysis.…”

Randomised controlled trial of telemedicine for new neurological outpatient referrals

“…In a recent pilot study we showed that it was feasible and safe for a neurologist to assess new referrals to a neurological outpatient clinic using telemedicine 6. Here we conducted a randomised controlled study to compare telemedicine with conventional face to face consultation for measures of process and patient satisfaction, to test the hypothesis that there would be little difference between the two methods.…”

Telemedicine and neurosciences

“…Clinical trials [45][46][47][48][49] have shown that teleneurological evaluation is as effective as a face-to-face evaluation. In one study, the concordance was 96%.…”